Employer
Pennsylvania Ambulance
1000 Dunham Dr, Dunmore, PA 18512 · EIN 46-2961683 · Sep 1, 2024 to Aug 31, 2025
Plan year 2024
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Schedule A
Direct compensation
Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 68 | Comp not disclosed Premium $198,649 |
Schedule C
Additional compensation
Plan-paid amounts to each named party on the filing, with the role they reported. This is not a carrier commission and is not added to Schedule A.
Visible subtotal $35,997
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $26,979 | $281.03 |
| Highmark Bcbs Nepa | Admin | $9,350 | $97.40 |
| Highmark Blue Shield (Central) | Admin | $-332 | $-3.46 |